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Friday, April 22, 2005

The figures above are from Pathological Basis of Disease by Robbins and Cotran.

Real Sex!

Dr. Lester CN Simon

The ABC lesson on HIV prevention teaches abstinence, being faithful to one partner and using a condom. We should analyse the relationship between HIV and the host to see how well we know our ABC lesson on HIV. The Art of War by Sun Tzu tells us, “If you know yourself but not the enemy, for every victory gained you will also suffer a defeat.”

Examination of the way HIV infects the body reveals some remarkable facts. The entire HIV spherical structure is called the virion. The actual virus or the dangerous, infective particle resides inside the virion as a cone-shaped core. It is surrounded by an envelope or coat, which may be considered to be equivalent to a condom. The release of the deadly virus from this protective sheath is afforded by a very intimate relationship between the invading virus and the host cell. (Refer to figures 1 and 2 as you read along).

Any virus, including HIV, will target only a particular type of cell rather than try to infect all the different cells of the body. Viruses are not as promiscuous as human beings. They want to live and they plan to continue being around for a very long time. A virus cannot reproduce by itself or by combining with another virus. It must find a suitable host to survive and proliferate, so it chooses its host wisely.

HIV infects the most important cell type in the body’s immune system. These are cells called T lymphocytes, a special type of white blood cell. This attack involves a process of attraction, fusion and penetration of the host. However, HIV does not simply and single-handedly violate the host. There is mutual interaction involving receptors on the host T cells fusing with HIV structures that are studding the protective sheath of the virus.

Truth to tell, the HIV virus displays a high degree of faithfulness to one partner by only having an intimate relationship with host cells that carry a particular receptor, called CD4. All of the other trillions of cells in the body without this CD4 receptor are ignored. These other cells are in abstention and cannot be infected at all. Unfortunately, these abstainers are part of the same, individual body and they too will be affected eventually by the action of the other cells. Let us take a peep at the wild, sexy titbits and see how HIV discards its protective condom and penetrates the accommodating host.

The studded structures of HIV are called gp120 and gp41 (figures 1 and 2). These names simply reflect their glyco-protein (gp) chemical nature. On the host T cells, there are two types of receptors that receive the HIV studs. One type of host receptor is the CD4 receptor mentioned earlier. Like many receptors, it extends from the inner aspect of the cell, through the cell wall or membrane to the external part of the cell. The other receptor on the host is called a chemokine receptor, CCR5. Chemokines are a family of proteins that primarily act as attractants.

To gain entry into the cells, one of the HIV studs, gp120, binds to the host CD4 receptor. This initial contact does not allow entry of the virus. The real, penetrative sex requires more negotiation, more courtship and more mutual stimulation. As the initial contact and signal transduction continue, they bring about an outstanding change in the HIV stud, gp120. The gp120 stud is now enticed by the attractant receptor on the host cell, CCR5, in addition to its initial contact with the host receptor, CD4.

With this two to one contact between the two receptors on the host and the gp120 stud, the second HIV stud, gp41, is charged into action. It springs outward towards the surface of the host to pierce it. The gp41 is the real stud. It is responsible for fusion with and penetration of the host. When it plunges itself through and beyond the outer confines of the host, the inner, naked virus loses its protective cover and is discharged into the compliant, submissive host. HIV infection begins.

If abstinence and being faithful to one partner fail, and you do not like to use condoms, you and HIV may have quite a lot in common. Considering that HIV does show some degree of cellular faithfulness and that other cells abstain from its sexual advances, your refusal to use a condom may be worse than the action of HIV itself.

Do not succumb to those charming ladies or gentlemen who, when you display a condom, look at you quizzically and say, with all the blessed assurance of a Luciferian angel, “Come, come my dear, just who do you really think I am? Let’s have some real sex.”

Sunday, April 17, 2005

In July 2003, a unique volcanic eruption took place in Montserrat. It is being hailed as a geological finding that has never been documented anywhere before. In a remarkable article in the March 26-April 1, 2005 edition of New Scientist, Christina Reed outlined the scientific path to this discovery with the opening remark, “When lava flows uphill, you know you’re in deep trouble.”

The Soufriere Hill volcano in Montserrat has seen off about 8,000 of the 12,000 inhabitants and invited a number of scientists to work at the Volcano Observatory. Christina Reed reported that in July 2003, the volcano staged its largest eruption since it became active in 1995. As the pyroclastic flow made its way towards the Atlantic Ocean, the scientists crowded the Volcano Observatory. During the 18 hours long drama, one of their volcanic sensors took a direct hit from the pyroclastic flow. A pyroclastic flow comprises ash, blocks of rocks and superheated steam.

After the tsunami a few months ago, we wondered about the possibility of one occurring in the Caribbean. Back in July 2003, as the pyroclastic flow in Montserrat discharged its contents into the Atlantic Ocean, Guadeloupe issued a radio report to say that a small tsunami had smashed 15 fishing boats. Meanwhile, more than 40 animals died on Montserrat in an area considered safe for animals.

The report in New Scientist is an excellent reminder of the power of keen observation, a fundamental requirement of any scientist. After the pyroclastic flow ended and it was safe, volcanologists Marie Edmonds and Richard Herd left their instrument panels in the Observatory and ventured out to get a real view of the damaged area.

According to Christina Reed, the dome at the top of the volcano had entirely collapsed and dumped around 200 million cubic meters of pyroclastic material into the Tar River valley. The Tar River valley is downhill of the volcano. It flows towards the Atlantic Ocean.

Something about the July 2003 volcanic eruption seemed odd. Near the Atlantic coastline, trees facing the ocean had rocks embedded in them only on their coastal side, which is the side away from the volcano. It was as if the pyroclastic down-flow from the volcano had passed the trees with relatively little damage, turned around when it reached the ocean and went back uphill with a greater force!

Force does make water go uphill and it does the same to pyroclastic flow. But what was this force? As the pyroclastic flow “back-back” or turned around, it traveled uphill for about 3.5 kilometers. It reached valleys that farmers had been told were safe for animals. Dozens of animals died.

A volcanologist must spend many hours inside and outside an Observatory recording and analyzing data. However, like all good scientists, volcanologists spends most of the time looking inside their head, thinking, trying to make sense of the reams of data collected.

What had caused the back flow of pyroclastic material? The first and obvious possibility was that the turbulent, downhill pyroclastic flow had hit an object and shot back up the hill. This has been known to happen and the back shot can be sideways or even back up the same hill from whence it came. This happened in 1902 when Mount Pelee erupted on Martinique. The only problem with this explanation was that in Montserrat, there were no such obstacles between the down flow, the Tar River and the Atlantic Ocean, to produce such a turbulent back flow.

The second possibility was that the flat Tar River delta had caused the pyroclastic flow to build and to back up. This was discounted when the volcanologists found large chunks of rapidly cooled volcanic rocks as far as 2 to 3 kilometers away from the parent, pyroclastic down flow. This separation of new, offspring volcanic rocks uphill from the parent rocks of the pyroclastic down flow was too great and wide to result from a mere splash back.

The only explanation the volcanologists were left with was as follows: When the down-flowing pyroclastic material hit the seawater, it caused a secondary eruption, a hydrovolcanic eruption.

The report by Edmonds and Herd of this first-time eruption was accepted for publication in the journal, Geology. They also presented their findings at the Western Pacific Geophysics meeting in Hawaii in 2004. Hydrovolcanic eruptions have been reported before. It was first observed in 1965 when lake water entered a volcano crater in the Philippines. But the discovery in Montserrat marked the first time this was documented in a river delta.

Normally, when a pyroclastic flow meets the sea, there are only small-scale interactions by way of local boiling of sea water and jets of dust and rock fragments (called tephra) shooting up into the air. Never before have such an explosion column and base surge been documented to occur and to thunder back onto the land. A base surge is the backward surge or discharge from the secondary explosions at the coast caused by the deadly mixture of pyroclast and sea water.

There is a lesson to be heeded here. There are many costal volcanoes all over the world. There should be larger buffer zones around coastal volcanoes to avoid the perils of a base surge after a secondary, hydrovolcanic explosion. More than 550,000 people live in the dangerous “red zone” between the sea and Vesuvius, the most dangerous, active volcano, in Italy.

In her excellent article in New Scientist, Christian Reed makes the tipping point that the death of dozens of animals in Montserrat in valleys that were considered safe for them is a forewarning to people worldwide who are living around coastal volcanoes.

About Me

The hard work and adversity of my
parents and the dedication of my teachers ignited in me a passion for arts and
science and an everlasting quest for knowledge.

I spent 13 years in Jamaica at UWI,
where I met my wife, Norma and we brought two wonderful children, Sawandi and
Sabriya, into this world. Sawandi is a doctor and musician and a Red Bull Music
Academy Winner. Sabriya has a Masters Degree in Psychology. She is the 2007
Jamaican National Visual Arts silver-medalist, a photographer and a poet.

I am the director of the Mount St.
John’s Medical Center laboratory. My wife and I manage our private lab, Medpath
Clinical Laboratory. I spent about 3 years in England pursuing additional
postgraduate training for periods from 3 months to 1 year. My understanding of
music is largely due to Melba Liston, former head of the Afro-American
department of the Jamaica School of Music.

I play the soprano, alto and tenor
saxophone. Other musical instruments I play or practice on include: single
tenor and double seconds steel pans, clarinet and bass clarinet, flute alto
flute and piccolo, violin, acoustic bass guitar, accordion, piano, harmonica,
English horn, bassoon.